الفهرس 
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Abstract
Diabetes mellitus is a chronic disease, with multiple serious complications, that needs constant medical attention due to the rise in prevalence worldwide.
Egypt is ranked the 10th of the top ten countries in the world in terms of the number of individuals living with diabetes, with a prevalence of 16.7% in Alexandria.
Diabetes mellitus is characterized by hyperglycemia caused by defects in insulin production, insulin action, or both.
The complications of DM can be divided into microvascular and macrovascular.
Hypertension is considered as one of the leading causes of premature morbidity and mortality worldwide and it is twice as common in individuals with diabetes compared to those without, and more than half of individuals with diabetes eventually develop hypertension as well.
Blood pressure should be measured in both arms, and in in those with systolic IAD of >10 mmHg, repeated measurements should be done for confirmation. Individuals with consistent systolic IAD of >20 mmHg would require further investigations for arterial disease.
Systolic IAD is defined as a systolic blood pressure difference of 10 mmHg or more between both arms, which is suggested to be due to atherosclerosis of the large vessels. The presence of a BP difference between the two arms is commonly found among individuals, with a normally accepted range of less than 10 mmHg.
Systolic IAD has received a lot of attention recently, since it has been linked to an increased risk of CVD incidence, PAD, and all-cause mortality. Nonetheless, it has been proposed that systolic IAD can be a good predictor of subclinical atherosclerosis and the consequent cardiovascular events.
The aim of this study was to identify the systolic IAD and study the relation between systolic IAD and target organ damage in T2DM patients in Alexandria.
This cross-sectional study was conducted on 120 patients with T2DM, which were recruited from inpatient and outpatient clinic of Diabetes and Metabolism Unit, Alexandria Main University Hospital.
All the participants in this study were subjected to thorough history taking, complete physical examination, lab investigations (glycemic profile, lipid profile and renal function tests) and fundus examination for detection of DR.
Blood pressure was measured in both arms and systolic IAD was calculated by the absolute difference of systolic blood pressure between both arms.
Ankle systolic pressure was measured using hand-held Doppler and ABPI was calculated.